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Archive January 2017 XVIII, No. 1

Staffing: The Benefits of Build-to-Order Instrument Sets

Unlock hidden efficiencies when you lighten your instrument trays.

Christopher Backous

Christopher Backous, MHA


instrument trays RIGHTSIZING Good things will happen when you eliminate all the unnecessary items from your instrument trays.

The key to improved OR efficiency might be hiding in an unlikely place: your overcrowded instrument trays. It's amazing how many good things have happened since we launched our build-to-order process and eliminated unnecessary items from our trays. For starters, sets are easier to assemble. We've improved throughput in the sterile processing department, so much so that we rarely have to delay start times because sets aren't back to the OR. We've also downsized many cumbersome instrument trays and decluttered our reprocessing area. And perhaps the most pleasant surprise of all: The OR and sterile processing are pulling in the same direction. All this from rightsizing our instrument trays, only filling them with the tools surgeons routinely use.

Who's using what?
How many of the instruments that your sterile processing techs clean, sterilize, repack and send to the OR get used? To find out, sit down with a willing surgeon and review his instrument preference list. Ensure the list is current and that every item on the list is sent to the OR for his cases. Next, have surgical techs go line by line down the list to note which instruments were used during cleanup after each case. Tracking real-time instrument usage for an extended period will provide an accurate idea of which tools surgeons really need. You might be surprised by the results. For example, we discovered that 60% of instruments contained in our sets were rarely used during orthopedic cases.

It's a meticulous and labor-intensive process to pick through individual instruments sent to the OR in order to separate used from non-used items, but being that deliberate is the only way to ensure you have the accurate information that's needed to make real change happen. When you're changing hearts and minds, especially in the OR, you have to drill down to the details in order to make your case.

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